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Licensed Vocational Nurse - LPN

Lancesoft

Please note: Actual location may vary., RI(remote)

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JOB DETAILS
SALARY
$26
SKILLS
Call Centers, Case Management, Clinical Competency, Clinical Medicine, Clinical Support, Communication Skills, Computer Skills, Computer Systems, Customer Support/Service, Data Entry, Data Management, Detail Oriented, Documentation, Establish Priorities, Health Plan, Healthcare, Healthcare Providers, Leadership, Licensed Practical Nurse/Licensed Vocational Nurse, Managed Care, Medical Office, Microsoft Office, Microsoft Windows Operating System, Multitasking, Nursing, Operational Communications, Operations Management, Organizational Skills, Patient Care Authorizations, Pharmacy, Presentation/Verbal Skills, Support Documentation, Telephone Skills, Typing, Writing Skills
LOCATION
Please note: Actual location may vary., RI
POSTED
23 days ago
Job ID: 26-55315
 
Position Type: Full time
 
Location: Remote
 
Work Type: Remote
 
Est. Pay Range: $26.00/hr. To $28.50/hr.
 
Schedule: Work hours vary from 8AM to 8PM CST. Training hours 8AM - 430PM CT. Mandatory OT.
 
Position Summary:    
  • The Licensed Practical Nurse (LPN) will provide processing and communication of Commercial Prior Authorizations (PA) reviewed by the Commercial PA team for Pharmacy benefits.
  • Reporting to the Pharmacy Operations Manager, working with physician office staff and customer service, admissions and pharmacy operations departments to communicate referral status.
  • You will also oversee fax processing and providing telephone call assistance for prescriber office staff, pharmacies and members based on program criteria.
  • Responsibilities include answering inbound phone calls, processing cases, loading authorizations, and making follow-up phone calls.
  • Maintaining complete and accurate, documentation of all necessary information is necessary and will involve computer system data entry, data management, and reporting.
Duties:
  • Review criteria-based prior authorizations following policy and procedure
  • Provide internal nurse support to the PA team and member services department Refer cases not meeting clinical criteria to the Pharmacist and MD team(s).
  • Shift priorities while exhibiting a high level of urgency with all calls and assignments.
  • You will work with pharmacists, other clinical colleagues, healthcare professionals and members.
  • Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.
  • Complete other PA assignments as delegated by the PA leadership team.
  • Utilization of clinical skills to support the documentation and communication of medical services and prior authorization determinations
  • Ability to multitask, prioritize, and effectively adapt to a fast paced changing environment
  • This position involves sedentary work with periods of sitting, talking, listening.
  • Work requires sitting for extended periods, talking on the telephone, and typing on the computer.
  • Position requires proficiency with computer skills which include navigating multiple systems and keyboarding
  • Excellent communication skills, both written and verbal
  • Must have regular and predictable attendance
  • Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve calls with a one call solution.
  • Performs other related projects and duties as assigned, including attending training sessions and development meetings.
Experience:
  • Minimum 2 years clinical experience as a LPN/LVN.
  • A LVN (Licensed Vocational Nurse) or LPN (Licensed Practical Nurse) that must hold an unrestricted license in their state of residence or a compact license.
  • Prior authorization experience or Case Management experience
  • 3+ years prior related clinical work experience
  • Ability to prioritize, quickly assess, manage multiple tasks and adapt to constantly changing situations.
  • Experience using MS Office and other Windows-based computer applications and phone use.
  • Digital charting
  • Managed care or health plan previous experience,
  • Call center experience
  • Multi-tasking experience
  • Prior remote experience preferred
  • Case Management experience
  • Prior authorization experience
  • High production experience
  • Excellent organizational skills. Strong detail orientation.
Education:
Minimum 2 years clinical experience as a LPN/LVN.
A LVN (Licensed Vocational Nurse) or LPN (Licensed Practical Nurse) that must hold an unrestricted license in their state of residence or a compact license.
 
Employee Benefits:
At LanceSoft, full-time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits:
  • Four options of medical Insurance
  • Dental and Vision Insurance
  • 401k Contributions
  • Critical Illness Insurance
  • Voluntary Permanent Life Insurance
  • Accident Insurance
  • Other Employee Perks
 
LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.
 
 

About the Company

L

Lancesoft

We are a $125 Million, NMSDC-certified Minority & Woman owned Workforce Solutions Company headquartered in the DC metro area with presence across US with global presence - Canada, Mexico, India, UK, Malaysia, Indonasia, Hongkong, Singapore, UAE. We are specialized in providing Workforce Solutions, SOW project delivery, Engineering Solutions, Creative Services. We currently support 100+ Fortune companies globally and across multiple industry segments. We are currently supporting several massive programs across industry segment nationally/globally (Intel, Ally, AMD, QUALCOMM, Morgan Stanley, Kraft/ Mondelez, MNP, Amdocs, Dell, SanDisk, Medtronic, Becton Dickinson, GE, Lockheed Martin, UTC, L-3 Communications, Caterpillar, BMW, Mercedes Benz, National Grid, Dominion, Energy Future Holdings, PSEG, 3M, Fidelity, Aetna, Humana, Johnson & Johnson, Pfizer, Merck etc). 

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, identity, national origin, disability, or protected veteran status.

COMPANY SIZE
2,000 to 2,499 employees
INDUSTRY
Staffing/Employment Agencies
FOUNDED
2000
WEBSITE
http://www.lancesoft.com/

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